Psychopharmacotherapy prescription and suicidal behaviour.

Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Consecutively, diagnosis and treatment of mental disorders has an impact on suicide rate. The studies that investigated the possible impact of psychopharmacotherapy prescription practise on suicide rate have been gathered in the present article. Ongoing discussion of potential benefits and risks of antidepressant treatment with respect to suicidal behaviours includes many ecological, or population- based, correlational studies of temporal or regional trends in suicide rates and rates of usage of modern antidepressants including SSRIs. A number of studies have found a relationship between increase in national antidepressant prescribing and declining suicide rates, with general agreement but some exceptions. In general, studies showed that increased prescribing of antidepressants may indicate improved diagnosis and treatment of depression. On the other hand, studies that investigated the impact of prescription of anxyolitics on suicide rate were scarce, although the ratio of anxiolytics to antidepressants has been described as a quality indicator regarding treatment of depression, which is in most cases combined with anxiety and increased suicide risk. Importantly, sedatives and hypnotics are widely prescribed to elderly persons with symptoms of depression, anxiety, and sleep disturbance, but studies demonstrated that sedatives and hypnotics were both associated with increased risk for suicide in the elderly. Finally, studies on antipsychotic prescription demonstrated that particularly treatment with clozapine decreased suicide mortality among individuals with schizophrenia and schizoaffective disorders and on the other hand lithium reduced suicide rate among individuals with mood disorders.